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. 2016 Mar;22(3):433-41.
doi: 10.3201/eid2203.150977.

Effects of Response to 2014-2015 Ebola Outbreak on Deaths from Malaria, HIV/AIDS, and Tuberculosis, West Africa

Alyssa S Parpia, Martial L Ndeffo-Mbah, Natasha S Wenzel, Alison P Galvani

Effects of Response to 2014-2015 Ebola Outbreak on Deaths from Malaria, HIV/AIDS, and Tuberculosis, West Africa

Alyssa S Parpia et al. Emerg Infect Dis. 2016 Mar.

Abstract

Response to the 2014-2015 Ebola outbreak in West Africa overwhelmed the healthcare systems of Guinea, Liberia, and Sierra Leone, reducing access to health services for diagnosis and treatment for the major diseases that are endemic to the region: malaria, HIV/AIDS, and tuberculosis. To estimate the repercussions of the Ebola outbreak on the populations at risk for these diseases, we developed computational models for disease transmission and infection progression. We estimated that a 50% reduction in access to healthcare services during the Ebola outbreak exacerbated malaria, HIV/AIDS, and tuberculosis mortality rates by additional death counts of 6,269 (2,564-12,407) in Guinea; 1,535 (522-2,8780) in Liberia; and 2,819 (844-4,844) in Sierra Leone. The 2014-2015 Ebola outbreak was catastrophic in these countries, and its indirect impact of increasing the mortality rates of other diseases was also substantial.

Keywords: Ebola virus; HIV/AIDS and other retroviruses; healthcare; malaria; mathematical model; mortality rate; mycobacteria; parasites; parasitic; tuberculosis and other mycobacteria; vector-borne infections; viruses; zoonoses.

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Figures

Figure 1
Figure 1
Health state transition diagrams for A) malaria, B) HIV/AIDS, and C) tuberculosis models for disease transmission and progression. T, patient was treated; NT, no treatment was provided; TF, treatment failure or default.
Figure 2
Figure 2
Sensitivity analysis of model outcomes to variation in treatment coverage during response to the 2014–2015 Ebola outbreak in West Africa. A) Guinea, B) Liberia, C) Sierra Leone, and D) all 3 countries. Treatment coverage of malaria, HIV/AIDS, and tuberculosis varied from 10% to 90% reduction compared with the coverage before the Ebola outbreak. Average additional attributable deaths from malaria, HIV/AIDS, and tuberculosis as well as total direct deaths from Ebola are shown. Estimates of additional attributable deaths were associated with considerable uncertainty and are not shown here.
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